Individual
MR. JOSEPH JENSEN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
907 N POPE ST, SILVER CITY, NM 88061-5150
(575) 388-1976
(575) 538-2339
Mailing address
907 N POPE ST, SILVER CITY, NM 88061-5150
(575) 388-1976
(575) 538-2339
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
16-1943
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000D1036
—
NM
05
—
99657
—
NM
Enumeration date
08/26/2016
Last updated
08/26/2016
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